脑实质内颅内压监护对小骨窗开颅治疗高血压幕上脑出血的应用研究

摘要

目的:探讨脑实质内颅内压监护在小骨窗开颅手术治疗幕上高血压脑出血患者中的应用及其价值.方法:选取70例小骨窗开颅治疗高血压幕上脑出血的患者,将其随机分为两组,35例患者术后采用脑实质内颅内压监控作为观察组,35例患者采取常规监测作为对照组,观察两组患者疗效,甘露醇使用情况及并发症发生情况.结果:观察组患者治疗总有效率为62.86%,对照组治疗总有效率为40.00%,两组差异显著(P<0.05).观察组甘露醇使用量明显低于对照组,使用时间较对照组明显缩短,两组差异显著(P<0.05).观察组急性肾功能不全及水电解质紊乱发生率为5.71%,对照组为28.57%,两组差异显著(P<0.05).观察组颅内感染发生率为14.28%,对照组为20.00%,两组无显著差异(P >0.05).结论:脑实质内 ICP 持续监护可对小骨窗开颅治疗幕上高血压脑出血患者的病情尤其是术后颅内压进行及时准确的判断,指导临床早期采取正确的治疗措施,提高治疗效果,同时,利于疗效判断,对治疗方案的选择和改进具有重大意义,避免盲目降压治疗引起的并发症的发生.%Objective: To study the application and value on monitoring of intracranial pressure with small bone window craniotomy on patients with hypertensive intracerebral hemorrhage. Method: Selected 70 cases who accepted small bone window craniotomy treatment for hypertensive intracerebral hemorrhage, they were divided into two groups, 35 patients had the brain monitoring brain essence monitoring of intracranial pressure as observation group, 35 patients take regular monitoring as control group, and then observe the curative effect, mannitol usage and complications between two groups. Result: The effective rate of observation group was 62. 86% , whiling the control group was 40. 00% , the difference between two groups was significant (P<0.05). The mannitol usage of observation group was significantly lower than the control group, and the time use was significantly shortened, two groups of significant difference (P<0.05). The observation group acute renal insufficiency and water electrolytes disturbance incidence is 5. 71% , while control group is 28.57% , the two groups (P<0.05). The observation group intracranial infection rate was 14. 28% and 20.00% in control group, no significant differences between the two groups (P >0.05). Conclusion: The continuous ICP brain essence monitoring can give a accurate exact judgment to small bone window craniotomy treatment to high blood intracerebral hemorrhage patients, clinical guidance early to take the right treatment measures to improve the treatment effect, at the same time, to judge curative effect of treatment options. It has significance to the treatment measures and improvement which avoid blind antihypertensive therapy cause complications.